Towards Standardization of Retinal Vascular Measurements: On the Effect of Image Centering.

Within the general framework of consistent and reproducible morphometric measurements of the retinal vasculature in fundus images, we present a quantitative pilot study of the changes in measurements commonly used in retinal biomarker studies (e.g. caliber-related, tortuosity and fractal dimension of the vascular network) induced by centering fundus image acquisition on either the optic disc or on the macula. To our best knowledge, no such study has been reported so far. Analyzing 149 parameters computed from 80 retinal images (20 subjects, right and left eye, optic-disc and macula centered), we find strong variations and limited concordance in images of the two types. Although analysis of larger cohorts is obviously necessary, our results strengthen the need for a structured investigation into the uncertainty of retinal vasculature measurements, ideally in the framework of an international debate on standardization.